Operators are getting hip to short-stay rehab opportunity

Nursing home chains are beginning to tap into a new revenue stream through their therapy divisions: short-term stay units.

Golden Gate National Senior Care's Aegis Therapies is the latest to embark on this path, opening six Orthopedic Centers of Excellence in skilled nursing facilities throughout the country. The centers are designed for short-term hip- and knee- replacement patients.
"We're trying to make it a trend," said spokesman Blair Jackson. "We're among the first that are going out there doing this."
Most of the Golden Gate facilities have converted wings for the new units, which have separate entrances from the traditional rehab units, Jackson said. The average length of stay in the centers is 10 to 14 days. The rehabilitation division of Genesis HealthCare also is opening similar units exclusively for orthopedic patients.
The Golden Gate facilities are expected to break even on the units after three years. Each facility, on average, is spending approximately $600,000 to refurbish a wing and create the new unit, Jackson said. After expenses and costs, each unit should see a net return of about $200,000 annually, he added.
The move is a reaction to the 75% Rule, a regulation that is slowly shifting the population
of hip- and knee-replacement patients to skilled nursing facilities from inpatient rehabilitation facilities. Currently, 60% of residents in an IRF have to have one of 13 certain qualifying criteria to receive Medicare funding. That percentage will increase.
"The centers fill a real need that is not being addressed elsewhere," said Maurice Arbelaez, president of Aegis Acute Rehab.

Fecal transplants should be considered for patients with recurrent cases of Clostridium difficile whose symptoms cannot be addressed by antibiotics, the Infectious Diseases Society of America said in new guidelines published Thursday.

Lawmakers took a long-standing industry complaint to the Department of Health and Human Services this week, telling Secretary Alex Azar that Medicare and Medicaid favor opioid prescription over non-addictive alternatives for treating chronic pain.